The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture / 대한족부족관절학회지

PURPOSE: This study was designed to evaluate the clinical efficacy of temporary K-wire fixation in F-plate fixation for displaced intraarticular calcaneal fractures. MATERIALS AND METHODS: Two groups (group 1 with F-plate fixation only and group 2 with temporary K-wire fixation and F-plate fixation) of patients were included in this study. The temporary K-wire was removed six weeks after the operation. Each group consisted of 33 cases. Rotational axis angles were measured radiographically and the foot and ankle outcome score (FAOS) was used for clinical assessment. RESULTS: In group 1, the mean rotational axis angle was reduced from 27degrees preoperatively to 5.59degrees postoperatively and the angle at last follow-up was 9.94degrees. There was an increase in angle of 4.35degrees between postoperative and the last follow-up measurement. In group 2, the mean rotational axis angle was reduced from 21.2degrees preoperatively to 4.39degrees postoperatively and the angle at last follow-up was 5.91degrees. There was an increase in angle of 1.52degrees between postoperative and the last follow-up measurement. Significant difference in the changes of rotational axis angle was observed between the two groups. However, no significant difference in FAOS was observed between the two groups. CONCLUSION: Temporary K-wire fixation can prevent reduction loss when treating displaced intra-articular calcaneal fractures with an F-plate.

Comparison of F Calcaneal Plate and Locking Calcaneal Plate Fixation Using an Lateral Extensile Approach to Intra-articular Calcaneal Fractures / 대한족부족관절학회지

PURPOSE: To evaluate the radiological and clinical results after open reduction and internal fixation with calcaneal F plate and locking calcaneal plate using lateral extensile approach in the treatment of intra-articular calcaneal fracture. MATERIALS AND METHODS: This study included 34 cases of 33 patients followed up for at least 6 months postoperatively. F plate was applied in 18 cases (Group 1), locking plate was used in 16 cases (Group 2) and compared radiological and clinical results between two groups. RESULTS: Radiollogically, the mean Bohler angle was improved from 5.5degrees preoperatively to 20.1degrees postoperatively and 18.8degrees at the last follow up in group 1 and 8.6degrees preoperatively, 21.4degrees postoperatively and 20.3degrees at last follow up in group 2. Bone union was observed in all cases and 4 cases of screw loosening were noted in Group 1 with extended fracture to anterior process. At the last follow up, both groups showed clinical results in American orthopedic foot and ankle society ankle hindfoot score, 76(77 in Sanders type II and 75 in type III) in group 1 and 72(73 in type II and 70 in type III) in group 2. CONCLUSION: F plate and locking plate showed firm fixation and satisfactory clinical results in the treatment of intra-articular calcaneal fracture. We suggest applying locking plate in cases with extended fracture to anterior process, considering screw loosenings in those who were treated with F plate fixation.

Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate

PURPOSE: To evaluate the clinical efficacy of F-plate in displaced intra-articular fractures of calcaneus. MATERIALS AND METHODS: Total 43 cases treated with F-plate and followed up at least six months postoperatively were reviewed. Radiographically, Böhler angle was measured and all cases were subdivided by Sanders classification. Each case was reviewed for the presence of local infection, traumatic arthritis, nonunion, and any breakage of plate or screw. Maryland foot score was used for clinical assessment and factors influencing on clinical results were determined. RESULTS: The mean Böhler angle was improved from 0.5° (range: -24.7~35.5°) preoperatively to 25.8° (range: 14.2~38.6°) postoperatively and the angle at last follow-up was 23.5° (range: 10.2~37.5°), showing about 2.3 degree decline compared to postoperative Böhler angle. There were two cases of F-plate breakage and two cases of screw breakage but the metal breakage did not affect any change in Böhler angle. Other complications were; five cases of traumatic arthritis, one case of varus malunion and one case of deep wound infection. According to Maryland foot score, there were 10 excellent, 22 good, 10 fair and 1 poor result. Furthermore, Age, pre-operative Böhler angle and the patient's expectation on financial compensation had significant influences upon the clinical result. CONCLUSION: F-plate fixation seems to yield firm fixation and satisfactory clinical results in the treatment of displaced intra-articular fractures of calcaneus.

Operative Treatment with the Plate Fixation in Intraarticular Calcaneal Fractures / 대한족부족관절학회지

PURPOSE: We evaluated the results of operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures. MATERIALS AND METHODS: From August 2003 to July 2006, twenty intraarticular calcaneal fractures which were operated with open reduction and internal fixation with F or H plates and screws were evaluated retrospectively. According to the Essex-Lopresti classification, 3 cases were tongue type and 16 were joint depression type. With the Sanders classification, 2 cases were II A type, 7 were II B, 5 were III AB, 2 were III AC and 3 were IV. We have analysed the Bohler angle, Gissane angle, and calcaneal width in radiologic evaluation, and evaluated clinical result according to the Creighton-Nebraska Health Foundation Score. RESULTS: Radiologic changes showed as follows: Bohler angle improved from 5.8 degrees to 25.9 degrees, Gissane angle from 119.0 degrees to 113.3 degrees, and calcaneal width from 50.4 mm to 37.8 mm. In the clinical results, excellent cases were noted in 8 cases, good in 8 cases, fair in 2 cases, poor in 1 case. CONCLUSION: Operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures was thought to be a useful operative method allowing anatomical reduction.

Mechanical Properties of F Plate in Intraarticular Calcaneal Fractures

PURPOSE: We evaluated the mechanical properties of F plate fixation comparing with Y plate and a screw fixation for the intraarticular calcaneal fractures using synthetic bones. MATERIALS AND METHODS: Using 12 synthetic calcaneal bones, newly designed F plate was compared with the Y-plate, most commonly used, regarding the change of Bohler angle and the displacement of the thalamic fragments of the calcaneus after axial compressive loading by Instron 6022. RESULTS: Y plate fixation lost 8degrees of Bohler angle in average after axial compressive load and 2.6degrees in F plate fixation. Thalamic fragments were displaced 1.72 mm in average in Y plate fixation group and 0.73 mm in F plate fixation group. CONCLUSION: F plate offered more firm fixation than Y plate in the intraarticular calcaneal fracture in the aspect of maintaining the Bohler angle and preventing displacement of the thalamic fragments of calcaneus against axial compressive loading.